Annual Dubin Breast Center Event Spotlights an Inspiring Patient Story

Eva Andersson-Dubin, MD, at podium, with panelist (left to right), David Anderson, MD, FACs, Anna Barbieri, MD, Jeffery Meckanick, MD, Cardinale Smith, MD, PhD, and Joseph Sparano , MD, FACP.

 

The annual Dubin Breast Center Fact vs. Fiction Luncheon and Symposium is a unique event that provides a forum for Mount Sinai leaders to share key insights about all aspects of breast cancer and healthy living, and to answer questions about emerging trends and the future of women’s health.

More than 130 people attended the event, which was held Wednesday, June 1 at The Harmonie Club in New York City.

The panel discussion was moderated by Elisa Port, MD, FACS, and featured a panel of experts, including David Anderson, MD, FACS; Anna Barbieri, MD; Jeffrey Mechanick, MD; Cardinale Smith, MD, PhD; and Joseph Sparano, MD, FACP. Watch the video here.

In opening remarks, Eva Andersson-Dubin, MD, Trustee of the Mount Sinai Health System and Founder of the Dubin Breast Center, noted how the Center continues to grow.

“Today we see an average of 180 to 200 patients a day, and since the day we opened we have seen 380,000 patients,” she said. “I am so thankful to everyone who works at the Center.”

One patient, Julie McAllister, shared her inspiring story. She was diagnosed with triple-negative breast cancer six years ago when she was 36 years old.

Julie McAllister tells her story of how the Dubin Breast Center helped her overcome triple negative breast cancer.

“I was in complete shock. I was young, very healthy, active a mother of two children–my youngest was just six months at the time,” she said. “There wasn’t any history of breast cancer in my family. Breast cancer wasn’t even a remote part of my reality. I truly didn’t know if and how I was going to survive. I kept thinking about my kids and how much of their life I was going to be around for, not to mention my husband and I wanted more children.“

Immediately after her initial diagnosis, Shari Brasner, MD, her OBGYN doctor, arranged for additional care. Eventually Ms. McAllister chose Mount Sinai for her treatment and surgery, and she was introduced to Hanna Irie, MD, PhD, who would become her oncologist.

“Dr. Irie was the best and felt like my lifeline during my treatment,” she said. “She was straightforward, incredibly smart, kind, and never made me feel like any of my questions and or fears were silly or unwarranted.” The doctor also helped her find a clinical trial to participate in once she completed her standard treatment.

Ms. McAllister would undergo a number of surgeries, five months of chemotherapy, six weeks of radiation, and then years of ongoing surveillance.

“Throughout all that time, I always felt like I was in the best hands and had the best doctors and nurses looking after me and never felt like a generic cancer patient or a statistic,” she said. “The nurses and staff were extremely warm and knowledgeable. The treatment rooms were comfortable, and I never felt alone.”

She added, “Cancer crushes you physically and mentally. It changes you, puts a fear in you that you never knew existed, and alters the way you think and worry for the rest of your life. But knowing that there are places like the Dubin Breast Center, that there are doctors like the ones I was fortunate enough to call mine, who can and will help treat and cure your cancer, is incredible. I am forever grateful for the treatment and care that I received.”

As a result, she was able to have another child, who was born just four months before the event at The Mount Sinai Hospital, two floors above the Dubin Breast Center.

The Dubin Breast Center at The Tisch Cancer Institute of the Icahn School of Medicine at Mount Sinai was created in 2011 to provide integrated care and services for every phase of breast health and care, including prevention, diagnosis, treatment, and survivorship. Clinicians and staff treat each person individually and holistically, with the goal of alleviating anxiety, enriching lives, and supporting emotional and physical well-being. The team works to advance the standard of care with innovative and emerging treatment, while researching life-saving options for the future.

Celebrating Fortitude and Achievement at a Rousing Master’s Commencement Ceremony

For the 220 master’s students who had started—and completed—their academic studies at the Graduate School of Biomedical Sciences at the Icahn School of Medicine at Mount Sinai entirely during the COVID-19 pandemic, it was an especially joyful in-person graduation at Stern Auditorium on Tuesday, June 21. This was an event that honored much more than degrees—this was a rousing celebration of the Class of 2022, a highly diverse group of students who displayed fortitude, resilience, and altruism as they worked together to achieve their career goals and to serve the Mount Sinai community during unprecedented times.

Click here to meet five of the graduating master’s students and learn more about their experiences and passions

 Eric J. Nestler, MD, PhD, Dean for Academic Affairs and Chief Scientific Officer for Icahn Mount Sinai, greeted the students and guests, saying that two words come to mind when he thinks of this class—grit and optimism. “Grit expresses the idea that a crucial component of success is a person’s ability to pick a goal and stick with it,” said Dr. Nestler. “Grit is interesting because empirical research has shown that it does not correlate with IQ or standardized test scores. Rather, it more closely maps an individual’s conscientiousness to work hard, with scruples and care, and to adapt to new experiences.”

Eric J. Nestler, MD, PhD, salutes the graduates’ grit and optimism at Master’s Commencement 2022

Dr. Nestler continued: “Optimism may seem like an ephemeral stance in today’s world,” but it “is especially poignant for today’s graduation because each of your master’s degrees…imbue you with the ability to make the world better.” Dr. Nestler is also Nash Family Professor of Neuroscience and Director of The Friedman Brain Institute.

Marta Filizola, PhD, Dean of the Graduate School of Biomedical Sciences, told graduates: “Class of 2022, as I stand here, I applaud your passion, your dedication, and your commitment to hard work. Your experience at the Graduate School has been like no other…Not only have you witnessed history at the Icahn School of Medicine at Mount Sinai during the COVID-19 pandemic, you have also helped make history with your extraordinary contributions to biomedical research and volunteer work across the Health System.”

Dr. Filizola added: ”We are proud of the diverse group of talented students graduating today, and, now more than ever, we see a need for that diversity in science and health care…You have seen your studies through and added to your growing abilities, and now, when they are needed most, you will be applying your new skills across biomedical and clinical research, data science, genetic counseling, public health, epidemiology, health administration, and health care leadership. We’ve worked together to prepare you to meet some of the greatest challenges these fields have ever faced, and we know you are ready for them.” Dr. Filizola is also the Sharon & Frederick A. Klingenstein/Nathan G. Kase, MD Professor of Pharmacological Sciences,  Professor of Neuroscience, and Professor of Artificial Intelligence and Human Health.

Dean Marta Filizola, PhD, congratulates the graduates at Master’s Commencement 2022

The Commencement address was presented by Torian Easterling, MD, MPH, the first Deputy Commissioner and Chief Equity Officer for the New York City Department of Health and Mental Hygiene who was appointed at the height of the pandemic in 2020. Dr. Easterling also received an honorary Doctor of Humane Letters degree for a career committed to combatting longstanding complex public health disparities that include violence, maternal health outcomes, and chronic disease.

Dr. Easterling received his Master of Public Health degree from Mount Sinai in 2012 and passionately addressed the graduates. “In my role at the Health Department over the last two and a half years, the more public facing part of my job has been to change people’s minds about vaccines,” he said. “But a more longstanding and behind-the-scenes parts of my work involves changing minds, both inside and outside the agency, around public health itself, around equity and why it matters, around why notions like equality and inclusivity and even diversity are insufficient to eliminate inequity and to make the larger changes we need.”

Torian Easterling, MD, MPH, Deputy Commissioner and Chief Equity Officer, NYC Department of Health and Mental Hygiene, is Commencement Speaker and receives an honorary degree at Master’s Commencement 2022

He added: “Around health inequity in particular, good intentions—without rigorous science and data-informed analysis, a clear-eyed understanding of root systemic causes, and a fierce ideology of purpose matched with boldness of vision—are stultifying…When I’m asked to describe the work I do, I can answer in one word—change, and the work of change comes in three main forms: changing minds, changing lives, and changing society.” He asked each graduate to join “in solidarity, resolving to change the systems that imprison far too many of us, and by never settling for good intentions.”

There are 220 graduates from nine programs: Master of Science in Biomedical Data Science (7); Master of Science in Biostatistics (5); Master of Health Administration (29); Master of Science in Health Care Delivery Leadership (11); Master of Science in Clinical Research (23); Master of Science in Biomedical Science (61); Master of Public Health (62); Master of Science in Genetic Counseling (12); and Master of Science in Epidemiology (10), which graduated its first class.

When the time came for graduates to receive their degrees, it was a boisterous audience that joined in the celebration. Beyond the formal handshakes, and smiles and hugs onstage, graduates could count on robust applause of friends and family, and special shouts of congratulations from all reaches of Stern Auditorium. This is the Class of 2022, of whom Dr. Easterling had said in his Commencement address: “You are not burgeoning health leaders. You’ve been health professionals and heroes for quite some time already. How about a huge round of applause for yourselves?”

 

Scenes From Master’s Commencement 2022

What Pride Means to Mount Sinai

The 52nd NYC Pride March kicked off in full force on Sunday, June 26, returning in person after a two-year hiatus. Mount Sinai displayed its pride down Fifth Avenue and the full spectrum of the Mount Sinai family—providers, researchers, support staff, students, and more—showed up to impress the importance of LGBTQ+ visibility and inclusivity in science, technology, engineering, mathematics, and medicine fields.

Mount Sinai Health System is committed to meeting the needs of LGBTQ+ patients, be it through the Mount Sinai Doctors or hospital networks, the Institute for Advanced Medicine, or the Center for Transgender Medicine and Surgery. In addition, the Health System’s dedication to LGBTQ+ representation in employment and training helped it earn a top score of 100 and the designation of “LGBTQ+ Healthcare Equality Leader” in the Human Rights Campaign Foundation’s Healthcare Equality Index earlier this year.

Check out the Mount Sinai contingent at this year’s Pride March:

Read more about LGBTQ+ health and how Mount Sinai champions this cause:

How to Find an LGBTQ+ Experienced Medical Provider and Why That’s Important

LGBTQ+ Health with Zoe Rodriguez, MD

Mount Sinai Creates LGBTQ+ Medical Fellowship That Will Serve as a National Model of Care

What to Expect When You Need to Take Your Child to the Emergency Room

It’s a moment every parent dreads. You believe your child needs critical medical care and decide you must go to the hospital.

Christopher Strother, MD, Director of Pediatric Emergency Medicine at The Mount Sinai Hospital, offers some helpful tips on when you should take your child to the emergency room and how to best prepare. The Mount Sinai Hospital recently completed a full renovation of the Children’s Emergency Department, which features state-of-the-art technology and treatment rooms, and specially trained staff.

What are the most common pediatric emergencies?

For children, the three biggest things that we see in the emergency department are infections, such as the flu, stomach viruses that can cause patients to get dehydrated, and high fevers. That’s followed by injuries: falls, broken arms, cuts, and head injuries. In New York, we also see a lot of patients with asthma, especially during the spring allergy season.

When should you take your child to the emergency department?

It’s a tough question. Anytime your child is in pain, or you’re scared, or you’re worried about their safety, we’re here for you 24/7. We’re there for anything, and if you think you need to see somebody right away and you’re not sure where else to go. There are many reasons to come to the hospital, such as severe pain or injuries, or anytime you’re worried about your child’s health and safety. The things we worry the most about are trouble breathing, dehydration, and major injuries.

How does the children’s emergency room at The Mount Sinai Hospital differ from a regular emergency room?

The biggest difference in a children’s emergency room is the people who work there. The doctors and nurses are all pediatric trained and comfortable taking care of sick children. If your child needs medications, an IV, or a procedure, the people who do that are trained to do it with children. We also have child life specialists who will help kids cope with the experience. Our staff will help your child be comfortable. They can educate you and your child on what’s happening and what’s going be next. Our expertise, our staff, and our training and the focus on children really set us apart.

What else is new at the Emergency Department?

The new Emergency Department is tailored to the needs of children and their families, with a separate space from the adult ED that is connected to all services within Mount Sinai Kravis Children’s Hospital.

We’ve increased the size of the Department as well as redone the entire space. It’s brighter and very child friendly, with lots of colors and other features that make the experience calmer and safer for kids. Video tablets have something to keep kids busy, distracted, and calm. We have a whole wall with an interactive video for the kids to look at. It feels like a family environment. We’ve also created are a “low-stimulation room,” which is a single room a little bit apart for children with autism or other neurodevelopmental challenges, where they can be quiet and calm. We also have a separate area with the most advanced equipment where we can take the best care of critically ill children.

How common are children only emergency rooms?

We’re lucky here in New York. We have several children’s hospitals in New York City and around the area. A lot of places in the country don’t have any. A major city might have one children’s emergency department. Most children who go to the emergency department in the United States go to a general emergency department. Pediatric emergency departments are a unique thing.

What else does Mount Sinai offer?

Mount Sinai has two other pediatric emergency departments, one at Mount Sinai-Union Square downtown and one at Mount Sinai Morningside on the Upper West Side. At all of the emergency departments throughout Mount Sinai Health System, we keep in touch with how they take care of children. So even if you’re not in one of our children’s emergency departments, our pediatric specialists are working closely with the other emergency department to make sure that your child gets the best care.

What are some tips for parents taking their child to the emergency room?

  • If possible, call your pediatrician first. Sometimes you’re worried. Things may look scary, and you feel you must go right away. If you have a minute to think about it, I always suggest giving your pediatrician a call if you can. It helps in a few ways. Sometimes talking to your pediatrician or your regular doctor can actually keep you from having to go. Sometimes they can make an appointment the next day or give you some advice that might allow you to stay home for this visit.
  • Be prepared to spend some time in the emergency department. If you need to go, be prepared to be there for a while. Bring a charger for your phone, and a book. A visit may last a couple of hours. It can take time to perform X-rays or tests.
  • ·Be ready to tell the medical staff about any medications your child is taking. Either bring the medications with you or write them down. It’s extremely helpful to the staff at the hospital to know what your child has taken already and when they took it. For example, if you have given Tylenol or Motrin, write it down. Let us know when was last time. Or if your child has any allergies to medications, let us know right away.
  • ·Let us know as soon as possible if your child has any chronic medical conditions. For example, if your child has sickle cell disease, when you come into the emergency department with a fever let the first person you talk to know they have a fever and sickle cell disease. Because that can change the way we approach a patient and the tests that are done. Be up front and an advocate for your child’s history.

First Person: Changing the Way We Respond to Errors Improves Patient Safety

Brian Radbill, MD, FACP, Chief Medical Officer, Mount Sinai Morningside, talks with Kim Keller and other staff about ways to develop a culture of safety.

Establishing a culture in which employees feel comfortable reporting safety events is one of the keys to achieving “zero harm” in health care because it allows hospitals to identify vulnerabilities in their care delivery systems.

Recently, a safety event in Tennessee that resulted in a nurse being convicted of criminally negligent homicide gained national attention for its criminalization of medical error. The verdict is expected to have a chilling effect on safety event reporting in hospitals across the nation that will ultimately make our health systems less safe.

Now is a crucial time for health care leaders to support front-line staff by promoting and properly implementing a system called Just Culture.

Brian Radbill, MD

Just Culture is a fair and just system of accountability that supports an organization’s values and reflects what we know about system design—systems are not perfect, and people make mistakes—when determining how we respond to a safety event. On the journey to “high reliability,” it is crucial that health care organizations develop a culture of safety and learning that respects and supports front-line staff.

Just Culture refers to a system used in a number of industries that is based on the principle that mistakes are generally the product of faulty organizational cultures, rather than the fault of one or more employees. The goal is to create an organization in which people report errors to help the organization learn from mistakes.

Historically, and even today, there is a perception that health care organizations remain overly punitive when responding to a safety event. Mount Sinai heard this from their own staff in the system-wide staff survey, Your Voice Counts.

Just Culture is not about creating a blame-free environment. It is about finding a fair balance where accountability is shared between the individual and the organization. The organization is responsible for designing and implementing safe systems and responding to safety events in a just manner. Individuals are accountable for the quality of their choices and for reporting errors or otherwise identifying system vulnerabilities.

Despite widespread recognition of the value of Just Culture, managers and leaders within health care often lack the necessary training to effectively and consistently respond to safety events in a manner consistent with Just Culture. In addition, most front-line staff have not been formally trained about Just Culture and are unaware of what it means to them.

To address these knowledge gaps and respond to concerns raised in the Your Voice Counts survey, leadership across the Mount Sinai Health System began working with David Marx, a pioneer in safety across several industries who is widely recognized as the “Father of Just Culture.” As part of that collaboration, Mount Sinai received training and educational materials to allow us to develop our own Just Culture “train-the-trainer” program. Originally intended as an in-person program, a virtual Just Culture training program was developed in response to the COVID-19 pandemic that allows participants to actively learn and engage with facilitators.

Recently, we began the first of several planned Just Culture Training for Managers programs within the Mount Sinai Health System. In order to make the program entertaining and leverage its online platform, the concept of the program is that participants are members of an at-home viewing audience watching a fictional morning talk show complete with hosts, guests, and even “commercial breaks.” Designated facilitators guide participants through a series of learning exercises in small breakout groups, culminating in their use of the Just Culture Company’s Just Culture Algorithm™ to work through two practice safety event cases.

In addition, after they have completed the half-day training, participants are instructed on how to educate staff about Just Culture within their unit or department. To strengthen the adoption of Just Culture, participants are invited to participate in monthly Zoom “lunch-and-learns” during which experts within the Health System discuss how to apply Just Culture in numerous industries.

Now more than ever, health systems need to work with front-line providers to create a culture of safety through a system of shared accountability. Just Culture training provides department heads, managers, nurse mangers, and other leaders with the tools to properly respond to a safety event to make our system of health care delivery safer. Through this training and associated education plan, the Mount Sinai Health System is committed to sustaining a workplace that ensures staff are treated fairly and patient safety remains at the center of everything we do.

For more information on Just Culture training at Mount Sinai, contact Shabona Akter, shabona.akter@mountsinai.org.

Brian Radbill, MD, Chief Medical Officer at Mount Sinai Morningside, is also a nephrologist who specializes in the treatment of chronic kidney disease. He earned his MD degree at Hahnemann University School of Medicine and trained as a resident and a fellow at the Icahn School of Medicine at Mount Sinai.

 

Computational Neuroscientist Opens Doors for New Ideas and Talent to Thrive

Computational Neuroscientist Opens Doors for New Ideas and Talent to Thrive

When Kanaka Rajan, PhD, an expert in neural networks, joined the Icahn School of Medicine at Mount Sinai in late 2018, it was the school’s way of investing in computational neuroscience. But since establishing her lab, she has achieved new heights not just in her area of study, but in paving roads for future diverse talents to enter what had been a rather homogenous field.

Dr. Rajan, an Assistant Professor of Neuroscience in The Friedman Brain Institute at Icahn Mount Sinai, was recently awarded the McKnight Scholar Award, a three-year honor that provides funding to early-career scientists, from the McKnight Foundation, a Minnesota-based organization that has supported work in arts and culture, neuroscience, and climate change.

“I am honored to be recognized by the McKnight Foundation this year. The announcement was such a pleasant surprise,” said Dr. Rajan. Awardees of such programs are not often pure theorists like herself, she said. But the less restricted nature of the funding will advance a new research direction her lab has taken on and will bring much needed exposure to a key problem in science: how does the brain work?

Growing the team

The Rajan lab builds recurrent neural networks—artificial networks of neural nodes or regions inspired by biological brains—toward two core goals. The first is to discover the pattern of cell activity and connectivity in the brain, especially in psychiatric disease models, using these networks. These include exploring how there might be unexpected similarities or differences across species.

One study in that vein was based on what Dr. Rajan calls “functional motifs”—brainwide neural maps that tracked motor dysfunction as a correlated passive coping mechanism, a trait associated with depression.

Larval zebrafish subjected to persistent stress were observed to shut down movement. By comparing computational models of the fish’s neural circuitry against what is known in similar studies in mice and humans, Dr. Rajan could extrapolate how multi-area brain communication and connectivity leads to behavior relevant to neuropsychiatric disease.

The second goal is studying the concept of generalized learning, in which skills learned for one task become applicable to other unrelated problems. This encompasses, among other things, how animals and people are able to multitask, and yet, unlike machines built with artificial intelligence, how people can fail to complete all or some of these tasks perfectly.

A recent breakthrough in generalized learning that Dr. Rajan is working on is getting recurrent neural networks to do “curriculum learning”—training them on designed syllabi of increasingly complex tasks.

The idea of curriculum learning is not new in psychology or cognitive neuroscience, in which animals learn through “shaping.” In a lab setting, animals can be shaped to perform a desired task through reinforcement, for example by rewarding successful completion of sequences of smaller tasks.

An illustrated look at Dr. Rajan’s work

Illustration credit: Jorge Cham

Using this method for recurrent neural networks was born partly out of recognition for how animals and children learn, and in part to address limitations of current training algorithms, Dr. Rajan said. She adds that her lab is among a handful to use curriculum learning in neuroscience, recognizing that understanding how people generalize requires understanding their full learning trajectory.

“It’s an exciting new chapter for this field and I’m hopeful the McKnight Scholar Award will help scale our efforts on this front,” Dr. Rajan said. Her team—comprising four postdoctoral researchers, some of whom are starting independent faculty positions later this year, and three graduate students—looks to add a few more members with the funding.

“This is a competitive field and city to hire scientists in,” she said. “Not only are we competing with other institutions; we’re also competing with industry, so it’s on us to make it an attractive proposition.”

But Dr. Rajan believes Mount Sinai offers something that other institutions or industry players might not: complete intellectual freedom.

“When I first arrived, I was told, ‘Welcome to the department. Let us know if you need anything,’ without any restrictions on my next steps,” Dr. Rajan recalled of her interactions with leadership in the Department of Neuroscience at Icahn Mount Sinai. “This was unlike previous institutions I had been at, where I had been gently nudged where I could or could not direct my research.”

Mapping new paths ahead

Just as Dr. Rajan felt she was given the opportunity to excel as a woman and person of color, she felt compelled to extend those opportunities to those who follow in her footsteps.

Dr. Rajan was allowed to tap her seed funding to start a pilot project in which she turned complex research papers into comic strips to get high school seniors and college students, especially those from disadvantaged communities, interested in joining the neuroscience field.

 

A peek at how Dr. Rajan makes complex research topics accessible to young students

Illustration credit: Jordan Collver

“There had been artificially high barriers to entry, like girls had been told they’re not good at math, or that AI and/or computational neuroscience are beyond their understanding,” Dr. Rajan said.

By turning complex ideas into jargon-free and engaging formats such as a comic strip, she hopes to help young students realize that they too can enter and flourish in such a technical field. A series of comic strips have been created and steps are underway to distribute them to schools in New York City and other cities.

“When I first started my lab, I had 116 applications to join my team. Guess how many were women?” Dr. Rajan asked. “Two. Computational neuroscience has a representation problem, and I want to fix what I can.” She continued, “I’ve taken small steps, but the ball rolled from Mount Sinai. Here, you see women really get to thrive.”

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